Gastric ulcers and GERD: the new "plagues" of the 21st century update for the clinical nurse specialist.

This brief overview explored the major medication therapies available for the treatment of GERD and gastric ulcers. These therapeutic agents have helped millions of people manage significant symptoms that negatively impact quality of life. A few words of caution are required when caring for the patient with GERD or ulcer disease. The CNS cannot conclude in the absence of symptoms that pathology does not exist. For each patient's plan, consider the risks and benefits of referral for diagnostic testing. Barium swallow or endoscopy may provide an invaluable benefit for diagnosis, monitoring responses to therapy, and may provide early identification of cellular abnormalities. Finally, in combination therapies (such as PPI and H2 antagonists), scheduling of doses is critical to achieve the best outcomes. Patients and families may need assistance of the CNS in designing a functional dosing schedule congruent with the demands of their lifestyles to achieve the best results.